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Cesarean section in Shanghai: women’s or healthcare provider’s preferences?

BACKGROUND: Cesarean section (CS) rate has increased rapidly over the past two decades in China mainly driven by non-medical factors. This study was to compare recalled preferences for CS among first-time mothers in early and late pregnancy with actual delivery mode; to explore factors related to CS...

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Autores principales: Deng, Wei, Klemetti, Reija, Long, Qian, Wu, Zhuochun, Duan, Chenggang, Zhang, Wei-Hong, Ronsmans, Carine, Zhang, Yu, Hemminki, Elina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4148545/
https://www.ncbi.nlm.nih.gov/pubmed/25148697
http://dx.doi.org/10.1186/1471-2393-14-285
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author Deng, Wei
Klemetti, Reija
Long, Qian
Wu, Zhuochun
Duan, Chenggang
Zhang, Wei-Hong
Ronsmans, Carine
Zhang, Yu
Hemminki, Elina
author_facet Deng, Wei
Klemetti, Reija
Long, Qian
Wu, Zhuochun
Duan, Chenggang
Zhang, Wei-Hong
Ronsmans, Carine
Zhang, Yu
Hemminki, Elina
author_sort Deng, Wei
collection PubMed
description BACKGROUND: Cesarean section (CS) rate has increased rapidly over the past two decades in China mainly driven by non-medical factors. This study was to compare recalled preferences for CS among first-time mothers in early and late pregnancy with actual delivery mode; to explore factors related to CS preference and CS performed without medical indications; and to consider the role of healthcare providers in delivery mode preferences. METHODS: An anonymous questionnaire survey, combined with data on CS indications taken from the patient record, was conducted among 272 first-time mothers having their first postnatal check-up in one university affiliated obstetrics and gynecology hospital in Shanghai, China, between September 2006 and January 2007. Logistic regression was used to study factors related to the recalled preference for CS and CS performed without medical indication, adjusting for maternal age, education and income. RESULTS: The CS rate was 57% (151/263) among all women, 17% with medical indications and 40% without medical indications. For women without medical indications for CS (n = 215), there was no significant difference between women’s preference for CS in early (25%) and late pregnancy (28%); 48% of women actually had CS. Women recalled preferring a vaginal delivery but who had CS were more likely to have had a CS suggested by a prenatal care doctor [OR (95% CI): 20 (3.88-107.1)] or by a delivery obstetrician [OR (95% CI): 26 (6.26-105.8)]. Among women recalled preferring and having CS, a suggestion from the prenatal care doctor to have CS was very common. CONCLUSIONS: In the primiparous women without a medical indication for CS, women recall of a provider suggestion for CS was a strong predictor of CS both among women who recalled a preference for CS and among women who recalled a preference for vaginal delivery. Public health education needs strengthening, including discussion of the risks associated with CS and psychological and social support given to women to help them prepare for and cope with childbirth. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2393-14-285) contains supplementary material, which is available to authorized users.
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spelling pubmed-41485452014-08-29 Cesarean section in Shanghai: women’s or healthcare provider’s preferences? Deng, Wei Klemetti, Reija Long, Qian Wu, Zhuochun Duan, Chenggang Zhang, Wei-Hong Ronsmans, Carine Zhang, Yu Hemminki, Elina BMC Pregnancy Childbirth Research Article BACKGROUND: Cesarean section (CS) rate has increased rapidly over the past two decades in China mainly driven by non-medical factors. This study was to compare recalled preferences for CS among first-time mothers in early and late pregnancy with actual delivery mode; to explore factors related to CS preference and CS performed without medical indications; and to consider the role of healthcare providers in delivery mode preferences. METHODS: An anonymous questionnaire survey, combined with data on CS indications taken from the patient record, was conducted among 272 first-time mothers having their first postnatal check-up in one university affiliated obstetrics and gynecology hospital in Shanghai, China, between September 2006 and January 2007. Logistic regression was used to study factors related to the recalled preference for CS and CS performed without medical indication, adjusting for maternal age, education and income. RESULTS: The CS rate was 57% (151/263) among all women, 17% with medical indications and 40% without medical indications. For women without medical indications for CS (n = 215), there was no significant difference between women’s preference for CS in early (25%) and late pregnancy (28%); 48% of women actually had CS. Women recalled preferring a vaginal delivery but who had CS were more likely to have had a CS suggested by a prenatal care doctor [OR (95% CI): 20 (3.88-107.1)] or by a delivery obstetrician [OR (95% CI): 26 (6.26-105.8)]. Among women recalled preferring and having CS, a suggestion from the prenatal care doctor to have CS was very common. CONCLUSIONS: In the primiparous women without a medical indication for CS, women recall of a provider suggestion for CS was a strong predictor of CS both among women who recalled a preference for CS and among women who recalled a preference for vaginal delivery. Public health education needs strengthening, including discussion of the risks associated with CS and psychological and social support given to women to help them prepare for and cope with childbirth. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2393-14-285) contains supplementary material, which is available to authorized users. BioMed Central 2014-08-22 /pmc/articles/PMC4148545/ /pubmed/25148697 http://dx.doi.org/10.1186/1471-2393-14-285 Text en © Deng et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
spellingShingle Research Article
Deng, Wei
Klemetti, Reija
Long, Qian
Wu, Zhuochun
Duan, Chenggang
Zhang, Wei-Hong
Ronsmans, Carine
Zhang, Yu
Hemminki, Elina
Cesarean section in Shanghai: women’s or healthcare provider’s preferences?
title Cesarean section in Shanghai: women’s or healthcare provider’s preferences?
title_full Cesarean section in Shanghai: women’s or healthcare provider’s preferences?
title_fullStr Cesarean section in Shanghai: women’s or healthcare provider’s preferences?
title_full_unstemmed Cesarean section in Shanghai: women’s or healthcare provider’s preferences?
title_short Cesarean section in Shanghai: women’s or healthcare provider’s preferences?
title_sort cesarean section in shanghai: women’s or healthcare provider’s preferences?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4148545/
https://www.ncbi.nlm.nih.gov/pubmed/25148697
http://dx.doi.org/10.1186/1471-2393-14-285
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